Abstract

Infection related to use of Intra-arterial Hemodynamic Monitoring Devices is a serious complication. In an attempt to decrease the risk of infection presterilized chamber domes were developed to isolate the patient vascular system from the pressure transducer. Users were informed by manufacturers of the domes that routine decontamination of transducer heads was not necessary. Since the development of these disposable chamber domes infection outbreaks have continued to occur. Epidemiological investigation has implicated contact transmission of bacteria due to poor handling techniques in some outbreaks. However, in other outbreaks the source of the epidemic was found to be contaminated transducer heads and no mode of bacterial transmission was identified. It appeared that transmission occurred at the transducer-dome junction.

In an attempt to identify whether electroshock, such as a patient might undergo during cardiac defibrillation, could allow bacterial transmission at the dome-transducer junction a number of domes were subjected to 400 watt seconds of electroshock. It was hypothesized that electroshock might damage the dome membrane or dome membrane seal in such a way as to permit bacterial passage past the membrane.

Domes were selected to represent two different manufacturers. Two series of domes were shocked once each and one series of domes was shocked 25 times each. The shocked domes and their controls were all mounted on a contaminated transducer while the domes were filled with sterile fluid. After undergoing electroshock the test domes and the unshocked control domes were placed on a contaminated wick for 48-72 hours, after which the fluid in the chamber domes was cultured to deter- mine if bacteria had passed the dome membrane. The results of the first two series showed that one control and one shocked dome had bacterial contamination in the dome innerspace with the test organism, Enterobacter cloacae. Both domes were of the same manufacturer and lot number. Two untested domes of that lot number remained and they were treated as controls. Following bacterial challenge both had the test organism cultured out of the dome innerspace. None of the other six lot numbers of domes demonstrated bacterial contamination.

In conclusion there was no evidence to suggest that electroshock at 400 watt seconds (joules) facilitated the passage of bacteria from a contaminated transducer past the disposable dome membrane. However, there was evidence to suggest that of the seven different lot numbers, one had a defect which permitted bacterial passage past the membrane into the presterilized chamber dome. Because of the possibility of such a defect to be present it is recommended that transducers be decontaminated prior to use with a disposable chamber dome, and that if used, any fluid in the dome - transducer junction be sterile.

LLU Discipline

Nursing

Department

Nursing

School

Graduate School

First Advisor

Frances P. Miller

Second Advisor

Harvey A. Elder

Third Advisor

Grenith J. Zimmerman

Degree Name

Master of Science (MS)

Degree Level

M.S.

Year Degree Awarded

1984

Date (Title Page)

6-1984

Language

English

Library of Congress/MESH Subject Headings

Electroshock Monitoring; Physiologic

Type

Thesis

Page Count

viii; 92

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

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